=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518364124
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DV LUXURY CAR SERVICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2014
-----------------------------------------------------
Last Update Date | 11/25/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1313 PROSPECT AVE
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10459-2207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-815-2727
-----------------------------------------------------
Fax | 718-313-0425
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1313 PROSPECT AVE
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10459-2207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-815-2727
-----------------------------------------------------
Fax | 718-313-0425
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RAMON PEREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 347-863-1952
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 344600000X
-----------------------------------------------------
Taxonomy Name | Taxi
-----------------------------------------------------
License Number | B01328
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------